Anne Limbourg, M.D., Assistant Professor
Board-Certified Specialist in Plastic and Aesthetic Surgery
Complications following a breast lift are rare—but cannot be ruled out entirely. Wound healing disorders, asymmetries, and scarring issues have specific causes and can be treated or corrected in most cases. Understanding the underlying factors allows for better assessment—and targeted action when necessary.
A breast lift is a complex surgical procedure that affects the skin, glandular tissue, and vascular structures simultaneously. Even with optimal planning and careful execution, the individual healing process may differ from expectations. This is not an exception, but a medical reality that should be discussed openly—before a decision is made, and especially if something goes wrong after surgery.
Priv.-Doz. Dr. med. Anne Limbourg, a board-certified specialist in plastic and aesthetic surgery in Hanover and a Focus TOP Physician for 2026, provides in this article a structured overview of the most common complications, their causes, and the options for addressing them.
Mastopexy is one of the most technically demanding procedures in breast surgery. It requires precise tissue planning, a well-thought-out scar design, and a pedicle placement tailored to the individual anatomy. Surgical factors that influence the risk of complications include:
Surgical care alone is not sufficient if patient-related factors hinder healing. The most relevant include:
The preoperative medical history is therefore not a mere formality—it is the foundation of any serious risk assessment.
The most common local complication following a mastopexy is impaired wound edge healing—partial separation of the suture (dehiscence) or superficial necrosis of the wound edges (wound edge necrosis). It typically occurs at the T-shaped intersection of the sutures, which bears the highest mechanical tension in the inverted-T technique.
The cause is usually a combination of:
Small dehiscences usually heal spontaneously with conservative wound care. In cases of more extensive complications, controlled wound management is necessary—in rare cases, surgical debridement. The resulting scar is wider than planned, but in most cases can be corrected later.
A seroma is a collection of fluid in the surgical area that occurs when lymph fluid or wound secretions are not completely reabsorbed. It presents as a soft, fluctuant swelling under the skin, typically in the first two to four weeks after the procedure.
Small seromas are monitored and often resolve on their own. Larger seromas are drained via puncture—an outpatient procedure. An untreated seroma can lead to scar tissue resembling capsular fibrosis or delay wound healing.
Hematomas result from secondary bleeding in the surgical area. They are less common than seromas but potentially more serious, as pressure on the surrounding tissue can impair blood flow. A clinically significant hematoma usually requires surgical evacuation.
Wound infections following mastopexy are rare overall, but occur more frequently in patients with compromised immune systems, diabetes, or extensive wound areas. Clinical signs include redness, warmth, swelling, and increased pain—possibly accompanied by fever.
Treatment involves topical or systemic antibiotics, depending on the severity; in exceptional cases, surgical wound revision is necessary.
Delayed epithelialization—the slow closure of open wound surfaces—is not an infection, but rather a disrupted biological healing process. It occurs more frequently in smokers, obese patients, and in cases of increased suture tension. Modern moist wound care and, in selected cases, vacuum therapy can accelerate the process.
Primary asymmetry occurs immediately after surgery and is often due to a preoperative breast imbalance that was not adequately addressed—such as differences in breast size, varying degrees of ptosis, or preexisting rib asymmetry. It can be minimized through careful preoperative planning, but cannot always be completely eliminated.
Secondary asymmetry develops only during the healing process. Causes include:
An initial assessment of whether asymmetry requires treatment should not be made before the healing process is complete. In mastopexy, this typically takes six to twelve months—swelling, scar maturation, and tissue redistribution can still significantly alter the appearance during this time.
Correction is indicated if, after the healing process is fully complete (at least twelve months), a clinically relevant and stable asymmetry persists that causes distress to the patient. The key distinction is:
The answer determines which surgical strategy is appropriate—and whether surgery on one or both sides is more advisable.
Scars from breast lifts run across areas subject to mechanical stress—particularly the inframammary scar (along the inframammary fold) and the vertical scar below the nipple are constantly exposed to tension and pressure. This explains why mastopexy scars are more prone to hypertrophy than scars in less mobile areas.
A hypertrophic scar is raised, reddened, and hardened—it does not extend beyond the original wound line but stands out within it. A keloid, on the other hand, grows beyond the edges of the wound and is genetically predisposed; it occurs disproportionately often in people with darker skin types.
Both forms result from excessive collagen production during the scar maturation phase. The process is not entirely predictable—but can be influenced by early intervention.
Conservative measures in the first few months after surgery:
Interventional and surgical options for persistent scars:
Revision surgery following a mastopexy is not a standard procedure—every revision is unique because it builds upon tissue that has already been operated on. The following questions must be answered before planning any revision:
Without clear answers to these questions, serious revision planning is not possible. At Dr. Limbourg’s practice, the previous surgery is therefore systematically documented through medical history and clinical examination—supplemented by imaging if necessary.
Depending on the findings, various surgical options are available:
For positional asymmetry (MAK too low, height difference): Correction through targeted skin excision or re-tightening of the affected side; periareolar technique well-suited for minor corrections
In cases of volume difference: autologous fat transfer to augment the smaller side; or adjustment of the glandular tissue through restructuring
For shape correction (too flat projection, irregular contour): Internal suture plasty to reshape the glandular body; supplemented with autologous fat if necessary
For scar issues: Scar excision with tension-free re-suturing; change in technique (e.g., switching from inverted-T to vertical scar) if clinically appropriate
For a combination of multiple issues: Gradual correction is often safer than a single comprehensive revision procedure—especially when blood supply reserves are already limited by scar tissue.
The most common mistake regarding revision requests is acting too soon. Patience is medically justified:
This recommendation applies to elective revisions. Complications such as persistent wound healing disorders or clinically relevant seromas require an earlier, situation-specific response.
How common are complications after a breast lift, really?
Serious complications, such as complete tissue necrosis or severe infections, are rare when performed by experienced surgeons. Milder delays in healing, minor wound edge dehiscence, or temporary asymmetry due to swelling occur more frequently and are generally easily treatable. You will receive a realistic assessment of your individual risk profile during the preoperative consultation.
After my breast lift, one side is higher than the other. What can I do?
First, wait until the healing process is complete—this can take up to twelve months. Many asymmetries correct themselves as swelling subsides and scars mature. If a noticeable, bothersome difference persists after this period, a specialist evaluation is recommended to discuss the appropriate correction strategy.
My scars from the breast lift are hard and raised. Is this normal?
Hypertrophic scars in the first six months are not uncommon—the tissue is still undergoing active remodeling. Silicone products, massage, and sun protection can positively influence this process. If the scars are still raised and unsightly after twelve months, interventional options such as corticosteroid injections or laser treatment are available.
Can revision surgery after a breast lift be more dangerous than the initial surgery?
In experienced hands, a carefully planned revision is safe—but more challenging than the initial procedure. Scar tissue alters the tissue architecture and blood supply. Therefore, a thorough preoperative examination and a clear indication are prerequisites. Early revisions performed under time pressure before scar maturation is complete should generally be avoided.
Is a breast lift with Dr. Limbourg also possible for revision patients?
Yes. The evaluation and surgical care of patients following unsatisfactory previous results is an integral part of our work. We deliberately take more time for these consultations—because anyone who has already had a difficult experience deserves a particularly careful, honest assessment without pressure.
Complications following a breast lift are not a sign of failure—they are medical events with specific causes that can be treated in most cases. Wound healing issues, asymmetries, and scarring problems follow biological principles that can be understood, identified, and addressed.
The most important step: a doctor who clearly communicates what to expect—and who, when problems arise, does not shy away but takes action. That is exactly our commitment.
Ob Veränderung, Korrektur oder Neuanfang – wir nehmen uns Zeit für Sie. In einem persönlichen Gespräch klären wir gemeinsam, was möglich ist und was wirklich zu Ihnen passt. Einfühlsam, ehrlich und auf Augenhöhe. Vereinbaren Sie jetzt Ihren Beratungstermin in unserer Praxis in Hannover.
